259489 06/14/16 +ur_t�gM
a`! CITY OF CARMEL, INDIANA VENDOR: 367001
Pb 2j ONE CIVIC SQUARE CAPITAL ONE COMMERCIAL CHECK AMOUNT: $*******134.47*
CARMEL, INDIANA 46032 PO BOX 5219 CHECK NUMBER: 259489
9M�roN`�O'` CAROL STREAM IL 60197-5219 CHECK DATE: 06/14/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350100 022686 134.47 7003731100074683
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
CAPITAL ONE COMMERCIAL ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
PO BOX 5219 IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
CAROL STREAM, IL 60197-5219 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$134.47 Payee
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Course Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
022686 43-501.00 $134.47 1 hereby certify that the attached invoice(s),or 5/30/16 022686 Shelter $134.47
1207 101 1207 101
bill(s)is(are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Friday,June 03,2016
I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have
audited same in accordance with IC 5-11-10-1.6
, 20—
Cost
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
cbsrco
w�,ro��r<r
Fortune Pair-k 43A7
9010 Michigan Road
Indianapolis, I.N.46268
1X Member 1117914346
RESALE ON
908881 SHELTER 119.99
617686 SOFTSOAP ,_ 8.99
E :81393 LIMES 5.49'. ,
RESALE TOTAL 134.,47
NON RESALE TOTAL 0.00
SUBTOTAL 134.47
TAX 0.00
*# TOTAL �MviyO
-- -- ---------------
XXXXXXXXXXXX4683 f. SWIPED /
Seq#: 10985, APP : 022686
Costco Wholesale _ Resp: APPROVED
Tran ID#: 6124000109 . ..r:
Merchant ID: 99034711
APPROVED - Purchase
AMOUNT: $134.47
05/03/2016 20_ ; -
21347 10216---
Costco WholesaleE '134.47
CHANGE 0.00
TOTAL NUMBER OF ITEMS SOLD = 3
)A141CMIC 20:21 347 10 216 36
Executive members earn a 2% reward
annually up to $750.00,.`or
approximately $2.66 on this
Purchase. -They also get added bent:
& lar-ser discounts on Costco Servi
Like Travel. See Membership for
exclusions and„details,
I
OP#: 36 Name: Jessica
Thank You !,
Please Come A S a
Whse:347 Trm:10 Trn:216 OP:36
I
COSTCO
Please Direct Inquires To: 1-800-220-8594
Account Number New Balance Payment Due Amount Past Due Due.Date
7003-731.1-0007-4683 $i34'41 $:00 .,$.00 06/20/201.6
N
Billing Datex.Credit,Line Available Credit
'05/26/2016 $2000 $1,865.53
O
Manage your account online at www.hrscommercial.com
N
STATEMENT OF YOUR ACCOUNT
FINANCE CHARGE SUMMARY
m
o Credit Credit Average Daily Corres- FINANCE ANNUAL New Minimum Promo
Plan Plan Daily Periodic ponding CHARGES at PERCENTAGE Balance Payment Expire
o Description Number Balance Rate APR Periodic Rate RATE Due
8 Reg 00014 $8.96 0.00000% 00.00% $.00 00.00% $134.47 $.00 06/26/2016
ACCOUNT DETAIL
Transaction Transaction
Invoice'. .< ;"_. User - P.O. Transaction
Date Description Number AD Number Amount
05/03/2016 COSTCO WHOLESALE-347 022686 0003 $134.47
0003 SUBTOTAL: $134.47
�mo COSTCO
ACCOUNT SUMMARY BALANCE SUMMARY
Outstanding
CURRENT. 1-29 DAYS PAST DUE ..30-69 DAYS PAST DUE _ Transaction $0.00
+New
$.00 $.00 $.00 Purchase(s)/Debit(s) $134.47
+New Fees $.00
0 60-89 DAYS"PAST DUE 90-119 DAYS PAST DUE 120-149 DAYS PAST DUE
o +Finance Charges $.00
0
o $.QQ $.00 $,QQ Payment(s) $.00
,160-179 DAYS PAST DUE 180+DAYS PAST DUE Credit(s) $.00
0
=New Balance $134.47
rn
s $.00 $.00
0
N
O
O
O
�2
0
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